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Job Summary

Serves as a liaison regarding the reimbursement, replacement, or provision of free medications to patients utilizing medication assistance programs for the uninsured, under-insured, indigent and for those who have exceeded their maximum level of insurance coverage. Monitors high cost medications for appropriate reimbursement. Communicates to the appropriate ambulatory and inpatient personnel billing codes for new medications as they are added to the formulary. Serves as a resource regarding eligibility criteria, enrollment requirements and contacts for all pharmaceutical manufacturer's medication assistance programs.

Job Duties

• Develops and implements the medication assistance program for eligible patients.
• Learns and understands the eligibility criteria and enrollment requirements of the various pharmaceutical companies' medication assistance programs.
• Maintains knowledge of various information resources available regarding pharmaceutical company-sponsored medication assistance programs.
• Serves as a liaison regarding medication assistance programs.
• Provides assistance to the customer regarding the completion of the proper paperwork for enrollment in the program.
• Communicates to the various customers the outcome of a patient's application for medication assistance and coordinates the resolution of the patient's account with appropriate business service coordinator regarding drug charges.
• Assists with the communication of new billing codes to the appropriate people as new medications are added to the formulary.
• Reviews and analyzes patient financial service reports to ensure correct coding, correct reimbursement, or the need to investigate appropriate indigent care programs.
• Monitors high-cost, targeted medications to ensure appropriate reimbursement.
• Communicates with appropriate business service personnel to help resolve issues that arise.
• Educates other healthcare providers and ancillary service personnel on current reimbursement issues regarding medications that are part of the medication assistance program.
• Maintains a database of the local pharmaceutical representatives and the medication assistance programs available.
• Completes, updates and corrects database files for all patients interviewed.
• Reports monthly results of all patients interviewed as to their results.

Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. *Relevant experience may be a combination of related work experience and degree obtained (Associate’s Degree = 2 years; Bachelor’s Degree = 4 years).

Education

High School Diploma or Equivalent (GED)- (Required)

Experience

Minimum of 4 years-Relevant experience* (Required)

Skills

Computer Literacy; Working Independently; Teamwork; Customer Service

About Geisinger

Founded more than 100 years ago by Abigail Geisinger, the system now includes ten hospital campuses, a 550,000-member health plan, two research centers and the Geisinger Commonwealth School of Medicine. With nearly 24,000 employees and more than 1,700 employed physicians, Geisinger boosts its hometown economies in Pennsylvania by billions of dollars annually. Learn more at geisinger.org or connect with us on Facebook, Instagram, LinkedIn and Twitter.

Equal Opportunity Employer

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws.

Our Vision & Values

Everything we do is about making better health easier for our patients, our members, our students, our Geisinger family and our communities.

KINDNESS: We strive to treat everyone as we would hope to be treated ourselves.

EXCELLENCE: We treasure colleagues who humbly strive for excellence.

LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow.

INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.

SAFETY: We provide a safe environment for our patients and members and the Geisinger family.

Our Benefits

We offer healthcare benefits for full time and part time positions from day one, including vision, dental and prescription coverage.